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You have probably heard the news of brave Angelina Jolie’s double mastectomy to reduce her risk of breast cancer. But why did she feel she had to take such drastic action, is she now completely safe and how do you know if you are at similar risk?

One in eight women will develop breast cancer, and many of us know at least one person who has battled the disease. The news broke recently that film star Angelina Jolie had a double mastectomy this year, meaning she had both breasts completely removed, in order to avoid breast cancer.


Why was this necessary?

Some cancers occur more often in people who have a faulty (or ‘mutated’) gene. For example, people with faults in the Breast Cancer I or 2 (BRCA1 or BRCA2) genes have a greater chance of developing breast and ovarian cancer than those with a normal gene

Miss Jolie had a family history of cancer – her mother developed breast cancer, and both her mother and grandmother died of ovarian cancer.It was found that Jolie had inherited the faulty gene and therefore had a much higher risk of developing breast and/or ovarian cancer like her Mom, than women without the faulty gene. 

This risk has been estimated to be as high as 87% for developing breast cancer and 54% for ovarian cancer – compared with 12% and 1% respectively in those with normal BRCA genes. 

The only way to reduce the risk is to remove the tissue in which the cancer develops – the breasts and the ovaries.

Is she entirely risk-free now?

No, the risk can never be completely eradicated as it is impossible to remove every last bit of tissue – particularly in the case of the breast, and she still carries the ‘faulty’ genes.  But her risk of breast cancer is now much less.  She will probably have her ovaries removed before she is 40 to reduce her risk of ovarian cancer too.

In 2-8% of cases of mastectomies like Jolie’s, they find that breast cancer is already present. But Jolie’s surgeons were very careful to check that the tissue removed was still healthy, and also checked out and marked the closest lymph nodes.

Why are lymph nodes important?

The lymphatic system is composed of vessels forming a network all over the body which carry a substance called lymph. Fluid from the cells of the body drains into the vessels , which filter it though small nodules called lymph nodes.  The lymph nodes contain specialized white cells able to deal with any infecting organisms found in the fluid.  When you have an infection such as a sore throat, you may be able to feel the lymph nodes in your neck, close to your lower jaw, as they swell when fighting infection.

In cases of breast cancer, the lymph nodes draining fluid from the breast can easily become ‘seeded’ with cancer cells and this is one of the ways the disease can spread.

In the case of Angelina Jolie, the surgeons traced the nodes nearest the breast (often found in the armpit) and found them to be clear of cancer. But they also marked them so they will be easier to find in future, so that if she does develop breast cancer they can easily recheck the nodes.

Continue reading after recommendations

  • vitals.nbcnews.com/_news/2013/05/16/18296909-doctors-detail-angelina-jolies-breast-surgery?lite
  • www.breastcancer.org/symptoms/understand_bc/statistics
  • www.pinklotusbreastcenter.com/breast-cancer-101/2013/05/a-patients-journey-angelina-jolie/
  • www.breastcancer.org/symptoms/testing/types/self_exam/bse_steps (breast self-examination instructions)
  • opera.macmillan.org.uk/result.jsp (online inherited risk assessment tool)

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